Ach: Lower Abdominal Cavity II Flashcards
What does the ductus deferens emerge from?
deep inguinal ring
What is the dilated terminal end of the ductus deferens?
ampulla
What forms the ejaculatory duct?
duct of the seminal vesicle with the ampulla of the ductus deferens
Where are the seminal vesicles located?
Base of the bladder lateral to the ampulla of the DD
What do the seminal vesicles do?
add fructose and alkaline fluid to semen
Where is the ejaculatory duct located?
It descends through the posterior part of the prostate to enter hte posterior wall of hte prostatic urethra.
What is the prostate and where is it located?
A gland that is inferior to the neck of the bladder and surrounds the prostatic urethra.
What does the prostate rest on?
UG diaphragm
What does the prostate secrete? Why is this important?
fluid, milky, alkaline fluid that neutralizes acidity of the vaginal tract and liquifies semen
Increases lifespan of sperm and improves chances of pregnancy
What does the prostate gland lie w/in and what is it surrounded by?
Sheath
dense plexus of veins
How does prostate cancer spread?
Metastasis of cancer cells occurs via connections to valveless vertebral venous plexus or to internal iliac vines.
What is the MC site of metastatic spread from the prostate?
bones, lungs, liver
What prevents urination during ejaculation?
Internal urethral sphincter contracts under sympathetic control
What are the 4 zones of hte prostate gland?
central
transitional (median)
peripheral (posterior)
anteiror fibromuscular
What zones are most often involved in benign hypertrophy of the prostate (BPH)?
Periurethral and transitional
BPH can lead to…
difficult but frequent urination, nocturia, decreased or intermittent force of stream, sensation of incomplete emptying of the bladder
What part of the prostate has the highest incidence of prostatic carcinoma?
Peripheral zone (easily palpated during digital rectal exam)
What is indicative of prostatic disease?
elevated PSA (doesn’t give precise information)
What is the MC procedure used to treat prostate cancer?
TURP
What are the three parts of the male urethra?
- prostatic (in the prostate)
- membranous (in the UG diaphragm)
- penile/spongy (penis)
Prostatic part of the urethra is responsible for…
involuntary continence
Membranous part of the urethra is responsible for…
voluntary continence (rigid muscular attachments)
Penile part of the urethra is…
distensible
What are the divisions of the uterus?
Fundus
Body
Cervix
What part of the uterus communicates with the uterine tubes?
Uterine body
What are the three parts of the cervix?
Internal OS>
cervical canal>
external OS
What is the difference between endometrium, myometrium and perimetrium?
endometrium- shed cyclically, menstruation
myometrium- thick, smooth muscle
perimetrium- peritoneum, CT
Anteversion of the uterus means…
the axis of hte cervix forms a 90 degree angle w/ the axis of the vagina
Anteflexion of the uterus means…
adult uterus is bent forward on itself at about hte level of hte internal os to form a 170 degree angle
When the bladder is full, the uterus is…
retroverted (inclined posteriorly)
What is the broad ligaments?
layers of peritoneum
What does the broad ligament enclose?
body of the uterus
What do you have to be cautious of during a hysterectomy?
Injuring the ureter. The ureter lies UNDER the uterine artery.
What occupies the mesosalpinx or the upper boarder of the broad ligament?
Uterine/fallopian tubes
What does the uterine tube do?
connects uterine cavity to peritoneal cavity
What are the 4 parts of the uterine tube?
- Uterine part
- Isthmus
- ampulla
- infundibulum containing fimbriae
Where does fertilization usually occur?
ampulla
What is an ectopic pregnancy?
When implantation occurs outside the uterus and in the wall of the uterine tube
What is a uterine tubal ligation?
tying off and cutting of the uterine tube preventing the fertilization of the ovum by motile sperm
What attaches the ovary to the back of the broad ligament?
Mesovarium
What is the suspensory ligament?
transmits vessels and lymphatics to the ovary from the abdomen
What is the round ligament of the ovary?
Attaches ovary to uterus
remnant of the upper part of the gubernaculum.
What is hte ovary covered by?
germinal epithelium that is continuous with the mesovarium
What are the fornices of the vaginal lumen?
anterior, posterior, right and left lateral
How is the vagina usually located?
posterosuperiorly at a 40-60 degree angle from the horizontal
What is culdocentesis?
When a long thin needle is inserted through the posterior fornix of hte vagina and into the rectouterine pouch to determine the presence of fluid. We do ultrasound now instead!
What main vessel serves the pelvis?
internal iliac artery
What are the branches of the anterior division of the common iliac artery?
umbilical
obturator
uterine
vaginal
inferior vesical (M)
middle rectal
internal pudendal
inferior gluteal
What are the posterior branches of hte internal iliac artery?
superior gluteal
Lateral sacral
iliolumbar
What is the largest branch that passes through the greater sciatic foramen between L4/5-S1?
Superior Gluteal Artery
What forms the pectinate line? What does the pectinate line indicate?
Anal valves
division between gut derived from hindgut vs proctodeum
What is hte difference in venous and lymphatic drainage above and below the pectinate line?
above- superior rectal veins–> portal system
below- middle and inferior rectal veins–> systemic circulation
What are crypts?
shallow depressions in the endothelium where anal glands open
What are anal columns?
folds of endothelium overlying superior rectal veins
What is an anorectal ring?
site where hte rectum turns back to become the anal canal
What are the transverse rectal folds?
folds of muscular layers nad mucosa (not true valves, but they do slow the movement of feces through the rectum)
What forms the internal anal sphincter?
circular longitudinal layers of gut
innervated by autonomic fibers
WHat forms the external anal sphincter?
thickened lowest part of hte pelvic diaphragm. It has subcutaneous, superficiala nd deep parrts.
What is the nerve supply to the external anal sphincter?
rectal branches of pudendal nerve
